The United States is confronting a new wave of the ongoing opioid crisis, currently wrestling with an alarming surge of overdose deaths attributed to a lethal concoction of stimulants and the potent synthetic opioid, fentanyl.
Researchers are now referring to this phenomenon as the ‘fourth wave’ of the opioid crisis.
The Current Landscape of U.S. Overdose Statistics
2016 signaled a significant escalation in the decades-long opioid crisis, driven primarily by the emergence of synthetic opioids. Notably, these substances were responsible for a substantial 75% of the over 100,000 drug overdose deaths recorded across the U.S. in 2021.
This apparent shift from prescription opioids to synthetic versions reveals the dynamic nature of the opioid crisis. However, researchers are now documenting an alarming development – the proliferation of polysubstance overdoses, where victims are imbibing more than one drug, predominantly a blend of fentanyl and stimulants.
The Rising Trend of Polysubstance Overdoses
From 2010 to 2021, the ratio of overdoses involving both fentanyl and a stimulant, typically cocaine or methamphetamine, swelled by over fifty times, as was documented in a study published in the journal Addiction.
Chelsea Shover, a medical professor at the David Geffen School of Medicine at UCLA and co-author of the study, revealed that the crisis that started with the over-prescription of opioids has now morphed into one dominated by stimulants and fentanyl.
Diving into the data collected from all recorded overdose deaths in the U.S. from 2010 to 2021 demonstrated that almost one-third of all fentanyl-related deaths were in conjunction with stimulants by 2021.
The specific stimulant consumed with fentanyl varied based on geographical location. The Northeast region predominantly reported cocaine use, while the West and Midwest leaned more towards methamphetamine.
Opioid Epidemic’s Fourth Wave
The present trend took shape in 2015 when stimulants gradually became more prevalent in fentanyl overdoses, thereby marking the commencement of this ‘fourth wave’. The constantly transforming profile of the most lethal drug combinations only serves to highlight the complexity of this crisis.
However, it’s worth noting that a portion of these combined overdoses could be attributed to the unexpected presence of fentanyl in various other illicit substances. In spite of this, Shover expounded that the majority of polysubstance use is intentional.
The so-called ‘speedballs’ or ‘goofballs’, a mixture of cocaine and heroin or methamphetamine and heroin respectively, have been in use for an extended period, exacerbating the situation.
The Concluding Fentanyl Observations
Anna Childress, an addiction medicine researcher at the University of Pennsylvania Perelman School of Medicine, critiqued the grim scenario brought about by the power of fentanyl. Deemed approximately 50 times stronger than heroin, fentanyl’s substantial potency can prove fatal to both primary opioid and stimulant users.
Given that fentanyl offers an intense yet swift high and that using it with a stimulant may prolong sensations of euphoria, it’s hardly surprising that there could be intentional comorbidity. Furthermore, as opioids and stimulants exhibit opposing effects on the body, users may resort to one to counteract the effects of the other.
Navigating the intricate, ever-adapting landscape of the opioid crisis requires nuanced approaches and relentless efforts. However, recognizing the rising tide of fentanyl coupled with stimulants provides a pivotal step towards combating this ‘fourth wave’.
